TRENTON – Whether brittle, mottled or cavity-ridden, children’s teeth will be the subject of passionate debate before regulators here tomorrow as supporters and detractors argue about mandating fluoride in the state’s public water supply.
Dentists, fluoride’s most vocal advocates, cite studies that show declining rates of tooth decay in states treating water with fluoride. They note that the federal Centers for Disease Control supports the policy, which they argue aids poor children in particular.
“It prevents a preventable disease – tooth decay,” said Arthur Meisel, executive director of the New Jersey Dental Association, which is petitioning the state Public Health Council to adopt regulations requiring public water suppliers to fluoridate and will state its case tomorrow.
“Dentists have been in favor of this for years,” he added.
Opponents argue just as strenuously, however, that the general population should not be subject to steady doses of a compound known to have ill effects when too-large doses are used. At the very least, fluoridated water stains a substantial number of children’s teeth, they say, also citing studies.
There has been a push across the country to institute the practice, which began after World War II. About two-thirds of the population nationally drinks fluoridated water.
New Jersey, by contrast, has largely eschewed the treatment, with slightly more than 15 percent of people here drawing water from fluoridated systems. Historically, it has been up to municipalities to decide if they want to treat, and in regions with shared water pipes, all municipalities must agree, water purveyors say.
“This has been a problem – New Jersey is way down on the bottom of the list,” said Arnold Rosenheck, an assistant dean at the University of Medicine and Dentistry of New Jersey’s Dental School.
But opponents of the treatment, who say more studies of the long-term effects of fluoride are needed, are pushing back.
“There is no public outcry that everybody wants fluoride in the water, and the targeted population is only the small group of young children. But they would be forcing everyone to drink fluoridated water,” said Nancy Browne Coleman, president of New Jersey Citizens Opposing Forced Fluoridation.
“Most canned and bottled foods are bottled in cities with fluoridated water – we don’t need more,” said Coleman, a self-described “former fluoride promoter turned activist.”
“It’s hard to measure,” she added. “I might drink a lot of water and you might drink less.”
The New Jersey Environmental Federation opposes the practice as well.
“We don’t believe we should be mass-medicating people who have no choice about being exposed,” said Amy Goldsmith, the group’s state director.
“We’re not opposed to fluoride, but we say you should do it topically – put it on your teeth,” she added.
Many public health officials believe it is beneficial at low doses but agree it becomes a problem at slightly higher ones.
“The big risk is if you overdose,” said Mark Robson, chairman of the Department of Environmental and Occupational Health at the University of Medicine and Dentistry of New Jersey’s School of Public Health.
About 1 part per million (ppm) is considered optimal, while long-term exposure to a slightly higher level – 4 ppm – can cause a crippling bone disease called skeletal fluorosis, said Fred Mumford, a spokesman for the state Department of Environmental Protection, which regulates fluoride in water. Levels in between can cause severe mottling of the teeth, he said.
“It is not a wide margin – people have to be mindful,” said Robson.
Water purveyors say the state’s having a large number of towns and the longstanding deference to home rule are two reasons so few places have fluoridated water.
A swath of central New Jersey – including Trenton and its suburbs, as well as towns in Middlesex, Somerset and Monmouth counties – does fluoridate. The state’s northern and southern regions by and large do not.
Trenton has been treating its water for several decades – so long, in fact, that several city officials said they were hard-pressed to remember when it began. It rarely comes up for discussion, they said.
Officials in nearby Hopewell Borough, which does not put fluoride in public wells, said there was no push to do it.
“It came up here in the mid-’70s, but it wasn’t acted on,” said David Misiolek, director of the borough’s water utility. “It has no benefit beyond a certain age.
“It’s a costly thing to get into – more trouble than it’s worth, in my mind,” he said, noting that water purveyors who use it have to adjust water to counter fluoride’s acidity.
In Bordentown City, which does not fluoridate, officials said there is “no real momentum either way.”
“There is not really a push for it, although parents just starting families will ask sometimes. I don’t hear too much about it,” said John Walls, operator of the city water utility.
If the state Public Health Council, which sets the state’s sanitary code, decides to propose mandatory fluoridation, the rules would be subject to public comment prior to a final decision.
Contact Tracey L. Regan at (609) 777-4465 or tregan@njtimes.com
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